32 tumours in one lung

‘He said it doesn’t look good
He said in fact it looks real bad
he said I counted thirty-two of them in one lung before
I quit counting them
I said I’m glad I wouldn’t want to know
about any more there being there than that….’

Commentary

The American short story writer and poet Raymond Carver died from lung cancer, aged 50, in 1988. In this poem, he gives a word for word conversation with the doctor who gave him his final diagnosis.

All medical students learn about how to break bad news to a patient. What this poem gives us is one patient’s direct and vivid take on how he receives and reacts to this news in real time. As a writer, he described himself as ‘inclined towards brevity and intensity’ and the poem clearly exhibits these qualities.

Carver finishes:

‘I jumped up and shook hands with this man who’d just
given me
something no one else on earth had ever given me
I may even have thanked him habit being so strong’

There is an irony in the way that Carver talks of his fatal diagnosis in this off hand, quasi-humorous way. The patient is left in no doubt about the diagnosis, and by implication his prognosis. So was this a successful consultation? Did the doctor break the news in a way that would fit with Good Medical Practice today?

Discuss…..

Further info

This poem is included in Tools of the Trade: poems for new doctors published by Scottish Poetry Library 2016